Surgical instrument

Abstract

The surgical instrument includes a distal tool, a rigid or flexible elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal members whereby any deflection of said control handle with respect to said elongated instrument shaft causes a corresponding bending of said distal motion member for control of said working member. The proximal movable member comprises a movable ring assembly supported from the handle and adapted for three dimensional motion relative to the handle. A manually rotatable member may be arranged adjacent to the control handle for manually rotating the instrument shaft and working member relative to the control handle. A locking member may be supported from the control handle. The locking member is manually operable by a user and includes a follower the position of which is responsive to the position of the movable members.

What is claimed is: 
     
       1. A medical instrument comprising:
 a handle; 
 a distal work member; 
 a proximal movable member controlled from said handle; 
 a distal movable member controlled from said proximal movable member to provide controlled movement of said distal work member; 
 an instrument shaft that intercouples said proximal and distal movable members; 
 and actuation means coupled between said movable members; 
 said handle having a ball end with an outer at least partially spherical surface; 
 said proximal movable member comprising a movable ring assembly supported about the ball end of said handle and adapted for multi-directional motion relative to the ball end of said handle; 
 said movable ring assembly including an annular rider having an inner concave surface that rides on and conforms to the outer at least partially spherical surface of the ball end; 
 said annular rider constructed and arranged for the multi-directional motion over the outer spherical surface of the ball end to, in turn, control multi-directional motion of said distal movable member; 
 wherein said actuation means comprises a set of cables, each having proximal and distal cable ends that couple between said movable members and further including a rotation knob coupled with the rider while rotationally mounted relative to the rider and a cable retainer supported by said rotation knob and for retaining proximal ends of said cables. 
 
     
     
       2. The medical instrument of  claim 1  wherein said cable retainer is an annular cable retainer and further including a locking member mounted on said annular rider and having locked and unlocked states; said locking member in said unlocked state enabling control of said distal work member via said movable members; and said locking member, in said locked state, holding said movable members in a desired fixed position. 
     
     
       3. The medical instrument of  claim 2  wherein said locking member, in the locked state, fixes the position of the proximal movable member by locking the annular rider to the ball end. 
     
     
       4. The medical instrument of  claim 1  wherein said distal movable member comprises a uni-body structure. 
     
     
       5. The medical instrument of  claim 1  wherein said rotation knob controls said distal work member to rotate about a distal work member longitudinal axis. 
     
     
       6. The medical instrument of  claim 5  wherein said rotation knob comprises an annular rotation knob that is coupled with the rider while rotationally mounted relative to the rider. 
     
     
       7. The medical instrument of  claim 1  wherein said movable ring assembly further comprises a locking member mounted on said rider, having locked and unlocked states and for engagement with the ball end in the locked state. 
     
     
       8. The medical instrument of  claim 1  wherein the proximal movable member also includes an outer bellows having proximal and distal ends with the proximal end thereof attached to the rotation knob for rotation therewith, said outer bellows constructed and arranged to provide torque transmission to the distal work member while providing axial compression and expansion to facilitate a bending action between the movable members. 
     
     
       9. The medical instrument of  claim 1  wherein said ball end has a split to receive a locking wedge to lock the position of the rider on the ball end. 
     
     
       10. The medical instrument of  claim 9  including a slide button mounted on the handle for controlling said locking wedge position relative to said ball end. 
     
     
       11. The medical instrument of  claim 1  wherein said instrument shaft has proximal and distal ends and further including bearing means in the ball end for rotational support of the proximal end of the instrument shaft. 
     
     
       12. A medical instrument comprising:
 a handle; 
 a distal work member; 
 a proximal movable member controlled from said handle; 
 a distal movable member controlled from said proximal movable member to provide controlled movement of said distal work member; 
 an instrument shaft that intercouples said proximal and distal movable members; 
 actuation means coupled between said movable members; 
 said handle having a ball end with an outer at least partially spherical surface; 
 said proximal movable member comprising a movable ring assembly supported about the ball end of said handle and adapted for multi-directional motion relative to the ball end of said handle; 
 said movable ring assembly including an annular rider having an inner concave surface that rides on and conforms to the outer at least partially spherical surface of the ball end; 
 said annular rider constructed and arranged for the multi-directional motion over the outer spherical surface of the ball end to, in turn, control multi-directional motion of said distal movable member; 
 wherein said movable ring assembly includes a rotation control member for controlling said distal work member to rotate about a distal work member axis; 
 wherein said rotation control member comprises an annular rotation knob that is coupled with the rider while rotationally mounted relative to the rider; and 
 a bearing means between the annular rotation knob and the rider and a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball end in the locked state. 
 
     
     
       13. The medical instrument of  claim 12  wherein said actuation means comprises a set of cables, each having proximal and distal cable ends, and that couple between said movable members and further including a cable retainer supported by said rotation knob and for retaining proximal ends of said cables. 
     
     
       14. The medical instrument of  claim 12  wherein the actuation means comprises a set of control cables, each having proximal and distal ends, and further including means for mounting the proximal ends of the cables at the annular rotation knob. 
     
     
       15. The medical instrument of  claim 14  wherein said means for mounting includes a separate cable retainer that is secured with and rotates with the rotation knob. 
     
     
       16. The medical instrument of  claim 15  wherein said locking lever is mounted on said rider and has a pad means for engagement with the outer at least partially spherical surface of the ball end. 
     
     
       17. The medical instrument of  claim 12  wherein said actuation means comprises cables and said rotation knob also includes a cable retainer for retaining the proximal ends of the cables, and further including bearing means supported in the ball end for rotational support of the instrument shaft. 
     
     
       18. A medical instrument comprising:
 a handle; 
 a distal tool; 
 a proximal movable member controlled from said handle; 
 a distal movable member controlled from said proximal movable member to provide controlled movement of said distal tool; 
 an instrument shaft that intercouples said proximal and distal movable members; 
 and actuation means coupled between said movable members and including at least a first cable set disposed between the proximal and distal movable members so that any movement of the proximal movable member causes a corresponding movement of the distal movable member; 
 a ball means supported by one of the instrument shaft and handle; 
 said ball means having an outer at least partially spherical surface; 
 an annular rider having an inner concave surface that rides on and conforms to the outer at least partially spherical surface of the ball means; 
 said annular rider constructed and arranged for motion over the outer at least partially spherical surface of the ball member based on relative motion therebetween; 
 and a locking member associated with the ball means for fixing the position of the rider on the ball means to thereby freeze the relative position between the proximal and distal movable members; 
 wherein said first cable set has proximal and distal cable ends that couple between said movable members and further including a rotation knob coupled with the rider while rotationally mounted relative to the rider and a cable retainer supported by said rotation knob and for retaining proximal ends of said cables. 
 
     
     
       19. The medical instrument of  claim 18  wherein said said proximal and distal movable members are bendable members. 
     
     
       20. The medical instrument of  claim 18  including a bearing means between the rotation knob and the rider and a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball means in the locked state. 
     
     
       21. A medical instrument comprising:
 a handle; 
 a distal tool; 
 a proximal movable member controlled from said handle; 
 a distal movable member controlled from said proximal movable member to provide controlled movement of said distal tool; 
 an instrument shaft that intercouples said proximal and distal movable members; 
 and actuation means coupled between said movable members and including at least a first cable set disposed between the proximal and distal movable members so that any movement of the proximal movable member causes a corresponding movement of the distal movable member; 
 a ball means supported by one of the instrument shaft and handle; 
 said ball means having an outer at least partially spherical surface; 
 an annular rider having an inner concave surface that rides on and conforms to the outer at least partially spherical surface of the ball means; 
 said annular rider constructed and arranged for motion over the outer at least partially spherical surface of the ball member based on relative motion therebetween; 
 a locking member comprising a locking lever; wherein the locking member is associated with the ball means for fixing the position of the rider on the ball means to thereby freeze the relative position between the proximal and distal movable members; 
 a rotation knob for controlling said distal tool to rotate about a distal tool axis, the rotation knob being coupled with the rider while rotationally mounted relative to the rider; 
 a bearing means between the rotation knob and the rider, and the locking lever being mounted on the rider, the locking lever having locked and unlocked states and for engagement with the ball means in the locked state. 
 
     
     
       22. The medical instrument of  claim 21  wherein said proximal and distal movable members comprise bendable members. 
     
     
       23. A medical instrument comprising:
 a handle; 
 a distal tool; 
 a proximal movable member controlled from said handle; 
 a distal movable member controlled from said proximal movable member to provide controlled movement of said distal tool; 
 an instrument shaft that intercouples said proximal and distal movable members; 
 and actuation means coupled between said movable members and including a set of cables, each cable of the set having proximal and distal cable ends, and coupled between the proximal and distal movable members so that any movement of the proximal movable member causes a corresponding movement of the distal movable member; 
 a ball supported by one of the instrument shaft and handle; 
 said ball having an outer at least partially spherical surface; 
 a movable ring assembly including a rider having an inner concave surface that rides on and conforms to the outer at least partially spherical surface of the ball; 
 a rotation knob coupled with the rider while rotationally mounted relative to the rider; 
 said movable ring assembly further including a cable retainer supported by said rotation knob and for retaining the proximal ends of said cables. 
 
     
     
       24. The medical instrument of  claim 23  wherein said cable retainer comprises an annular cable retainer that is supported by said rotation knob for rotation therewith and that is for retaining proximal ends of said cables. 
     
     
       25. The medical instrument of  claim 24  including a locking member associated with the ball for fixing the position of the rider on the ball to thereby freeze the relative position between the proximal and distal movable members. 
     
     
       26. The medical instrument of  claim 23  including a locking mechanism associated with the ball for fixing the position of the rider on the ball to thereby freeze the relative position between the proximal and distal movable members. 
     
     
       27. The medical instrument of  claim 26  wherein the locking mechanism includes a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball in the locked state. 
     
     
       28. The medical instrument of  claim 27  wherein the locking lever includes a pad means for engagement with the outer at least partially spherical surface of the ball. 
     
     
       29. The medical instrument of  claim 23  wherein the handle is maintained in line with the instrument shaft, and the rotation knob is manipulated to both rotate relative to the ball, as well as to move on the ball in any direction. 
     
     
       30. The medical instrument of  claim 23  wherein the ball is attached to a proximal end of the instrument shaft and the rider is formed integral with the handle. 
     
     
       31. The medical instrument of  claim 23  wherein the ball is formed with the handle and the movable members are bendable members. 
     
     
       32. The medical instrument of  claim 31  including bearing means supported in the ball for rotational support of the instrument shaft. 
     
     
       33. The medical instrument of  claim 23  wherein the proximal movable member includes a bellows having proximal and distal ends with the proximal end thereof attached to the rotation knob for rotation therewith, said bellows constructed and arranged to provide torque transmission to the distal tool while providing axial compression and expansion to facilitate a bending action between the movable members. 
     
     
       34. The medical instrument of  claim 23  wherein the movable members are bendable members. 
     
     
       35. The medical instrument of  claim 23  including bearing means disposed between the rotation knob and the rider. 
     
     
       36. The medical instrument of  claim 23  wherein the rider is integrally formed with the handle and further including a locking mechanism carried by the rider. 
     
     
       37. The medical instrument of  claim 36  including a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball in the locked state. 
     
     
       38. The medical instrument of  claim 36  wherein the ball is attached to a proximal end of the instrument shaft and the handle bends or deflects at the rider relative to the ball. 
     
     
       39. The medical instrument of  claim 38  wherein the locking mechanism includes a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball in the locked state. 
     
     
       40. The medical instrument of  claim 23  wherein the ball is integrally formed with the handle, the handle is maintained in line with the instrument shaft, and the rotation knob and rider are manipulated to both rotate relative to the ball, as well as to move on the bail in any direction. 
     
     
       41. The medical instrument of  claim 40  including bearing means supported in the ball for rotational support of the proximal end of the instrument shaft. 
     
     
       42. The medical instrument of  claim 40  including a locking mechanism carried by the rider.